Don't Forget the Bubbles

MARCH 21, 2025

Thats exactly what Shane George et al. set out to explore in the Kids THRIVE study investigating whether NHF apnoeic oxygenation could improve intubation outcomes in critically unwell children needing emergency airway management. George S, Williams T, Humphreys S, et al. CASP checklist How good was the paper?

ICU 108

ICU Critical Care ED OR 108

The Skeptics' Guide to EM

NOVEMBER 18, 2017

[display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Critical Care Medicine 2017. Outside his family and work, Jesse pours […] The post SGEM#195: Some Like It Hot – ED Temperature and ICU Survival first appeared on The Skeptics Guide to Emergency Medicine. Critical Care Medicine 2017.

ICU 130

ICU ED Emergency Department Critical Care 130

ALiEM

FEBRUARY 5, 2024

Reference Lin M, Phipps M, Chan TM, et al. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. You will need to create a free, 1-time login account. Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011

Overdose 215

Overdose Critical Care EMS Emergency Department 215

Critical Care Scenarios

JUNE 14, 2020

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. Figure 1 from Srour et al (vide infra). 1 mg/kg ketamine* 2 mg/kg propofol*.3 3 mg/kg etomidate* 4 mg/kg thiopental Resources The SAVIOR algorithm.

Critical Care 130

Critical Care ED ALS OR 130

Pediatric EM Morsels

SEPTEMBER 22, 2023

Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Treat patients suspected of having neurogenic shock with warming and vasopressors. They may even need atropine and/or pacing for persistent bradycardia. References Coleman-Satterfield, TT. 5 th Edition. Neurogenic Shock.

E-9-1-1 304

E-9-1-1 Epinephrine ALS EMS 304

The Skeptics' Guide to EM

JUNE 12, 2022

Date: June 12th, 2022 Reference: Finfer et al. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in the Department of Critical Care Medicine at Mayo Clinic Arizona.

ICU 133

ICU Plasma Critical Care ALS 133

The Skeptics' Guide to EM

OCTOBER 3, 2021

Date: September 28th, 2021 Reference: Zampieri et al. Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. Date: September 28th, 2021 Reference: Zampieri et al. Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial.

OR 130

OR Critical Care ICU Plasma 130

The Skeptics' Guide to EM

OCTOBER 8, 2022

Date: September 15, 2022 Reference: Ramnarayan P et al. Effect of high-flow nasal cannula therapy vs continuous positive airway pressure therapy on liberation from respiratory support in acutely ill children admitted to pediatric critical care units: a randomized clinical trial. In 2018, Ramnarayan et al.

Critical Care 130

Critical Care ALS Emergency Department ED 130

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Date: January 29th, 2020 Reference: Perry et al. Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Date: January 29th, 2020 Reference: Perry et al. Reference: Perry et al. He also has this amazing #FOAMed blog called EM Nerd.

Emergency Department 130

Emergency Department Critical Care ALS EMS 130

ALiEM

APRIL 12, 2024

Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency department (ED) for shortness of breath and was found to have a left sided parapneumonic pleural effusion (Figure 1). doi: [link] Broder JS, Al-Jarani B, Lanan B, Brooks K. doi: [link] Vetrugno L, Guadagnin GM, Barbariol F, et al.

E-9-1-1 183

E-9-1-1 ALS Critical Care Emergency Department 183

Broome Docs

JANUARY 27, 2025

100% seems too good to be true Morello et al., European Journal of Internal Medicine , [link] You can listen to my 27-minute rant on Youtube here: [link] This multinational trial looked at a three-pronged diagnostic protocol in the ED for adults with suspected acute aortic syndromes. Did they pick a heap of PEs?

ED 101

ED OR ACS Critical Care 101

The Skeptics' Guide to EM

JUNE 22, 2024

Reference: Peters MJ, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-picu): a UK multicentre, open, parallel-group, randomised clinical trial. Dr. Anireddy Reddy Case: A 3-year-old girl presents to the emergency department (ED) with fever and respiratory distress.

Critical Care 141

Critical Care ICU ALS Emergency Department 141

ALiEM

OCTOBER 14, 2023

Reference Lin M, Phipps M, Chan TM, et al. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011

Critical Care 169

Critical Care EMS Emergency Department ALS 169

The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med.

CPR 130

CPR ICU Critical Care Defibrillator 130

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. 2012.05.028 Silvagni D, Baggio L, Mazzi C, et al. doi:10.1111/1742-6723.12389 Zhu S, Zhu J, Zhou H, et al. and Seaver, M.

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

Critical Care Scenarios

MAY 31, 2020

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. Figure 1 from Srour et al (vide infra). Resources The SAVIOR algorithm. References * Srour H, Shy J, Klinger Z, Kolodziej A, Hatton KW.

Critical Care 100

Critical Care Epinephrine ED ALS 100

Pediatric EM Morsels

JULY 5, 2024

Using this decision rule would have cut down on ED CT C-spine ordering by >50% in this derivation cohort. I am hopeful it will also improve the flow in the ED.” While plain films for C-spine injury had previously fallen out of routine ED practice, we now have more evidence to support their use in intermediate risk patients.

ALS 164

ALS OR ED Emergency Department 164

The Skeptics' Guide to EM

JUNE 18, 2022

Date: June 18th, 2022 Reference: Crombie et al. Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial. Date: June 18th, 2022 Reference: Crombie et al. Reference: Crombie et al.

Plasma 100

Plasma Critical Care Paramedic ALS 100

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. Case: A code blue is called for a 71-year-old male in-patient that is boarding in the emergency department (ED). JAMA Sept 2021. JAMA Sept 2021.

Epinephrine 100

Epinephrine Critical Care Life Support Emergency Department 100

The Skeptics' Guide to EM

MAY 11, 2019

Date: May 6th, 2019 Reference: Sceats et al. His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. Date: May 6th, 2019 Reference: Sceats et al. Omar et al (2008) showed just how safe laparoscopic appendectomies have become.

Critical Care 100

Critical Care ALS ED OR 100

Broome Docs

OCTOBER 6, 2024

Turgeon AF, Fergusson DA, Clayton L,et al. PMID: 38238065 Oral vs IV ABs… another negative trial Nielsen AB, Holm M, Lindhard MS, et al. Trends in Anaesthesia and Critical Care. So follow along with the papers below and read to make up your own mind about the evidence presented. Too much ‘aint enough blood?

Critical Care 102

Critical Care ALS Emergency Department EMS 102

The Skeptics' Guide to EM

MARCH 7, 2020

Date: March 4th, 2020 Reference: Radonovich et al. N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel. Date: March 4th, 2020 Reference: Radonovich et al. N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel. A Randomized Clinical Trial.

Emergency Department 100

Emergency Department Critical Care ALS ED 100

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 18 This trial showed significant improvement in performance of patients treated with ECMO compared to standard care with regard to survival to hospital discharge, survival at six months, and overall functional outcome.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

The Skeptics' Guide to EM

JULY 16, 2022

Date: July 16th, 2022 Reference: Lamontagne F et al. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Date: July 16th, 2022 Reference: Lamontagne F et al. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. She is admitted to the intensive care unit (ICU) for septic shock.

ICU 100

ICU ALS Critical Care Emergency Department 100

Don't Forget the Bubbles

JUNE 30, 2023

She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. CRITICAL CARE CASE REPORTS: METABOLIC, RENAL, AND ENDOCRINE , pp. Mazur P, Kosinski S, Podsiadlo P, et al.: Meert et al. CRITICAL CARE CASE REPORTS: METABOLIC, RENAL, AND ENDOCRINE , pp.

CPR 145

CPR Life Support Critical Care ALS 145

ACEP Now

AUGUST 14, 2024

Rate Versus Rhythm in the ED The 2023 AHA/ACC guideline doesn’t give explicit recommendations or preference regarding initial rate or rhythm control strategy for new-onset AF patients who are hemodynamically stable. based care of ED patients with AFRVR. References Joglar JA, Chung MK, Armbruster AL, et al.

ALS 105

ALS Emergency Department ED OR 105

REBEL EM

JUNE 8, 2023

Paper: Singer S, et al. The safety and efficacy of push dose vasopressors in critically ill adults. This study chose a relevant topic to analyze that could influence acute management in the ED and has a fairly larger sample size of patients to do so. References: Singer S, et al. PMID: 36108346 Cole JB, et al.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

Dr. Smith's ECG Blog

JUNE 2, 2023

Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED. They are rare and hard to find in normal practice in the ED. She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think?

ED 96

ED OR ALS CAD 96

EMDocs

JUNE 22, 2024

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. We’ll keep it short, while you keep that EM brain sharp. She had a precipitous delivery while the ambulance was pulling in.

EMS 111

EMS FFP Ambulance ICU 111

Don't Forget the Bubbles

AUGUST 23, 2023

Very rarely are the ED team allowed to stand, in silence, with a purpose. Kapoor et al. Critical Care Medicine , 46 (1), pp. It gives us permission to stop, breathe, recognise the enormity of what has happened, and provide a platform for acknowledgement. The Pause allows us to take the foot off the pedal briefly.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. References: Powers WJ, Rabinstein AA, Ackerson T, et al. Leonardi-Bee J, et al; IST Collaborative Group. Okumura K, et al. Oliveira-Filho J, et al. 119.025514.

ALS 99

ALS Critical Care OR EMS 99

Critical Care Scenarios

NOVEMBER 15, 2020

Takeaway lessons Many decisions in the ED are less about what to do, and more about when to do it. Takeaway lessons * Many decisions in the ED are less about what to do, and more about when to do it. Time and location are key considerations for efficient care.* Goals of care starts in the ED, and not with lip service.

ICU 100

ICU Life Support Emergency Department ED 100

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. However, education and training for healthcare professionals traditionally prioritise ‘hard skills’, particularly critical care resuscitation. Frich JC, Brewster AL, Cherlin EJ, Bradley EH.

E-9-1-1 105

E-9-1-1 Critical Care CPR ICU 105

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). His blood sugar was normal en route to the ED, and his initial rhythm on the cardiac monitor was asystole. Carsten L, et al. Crit Care Med.

Defibrillator 109

Defibrillator CPR Epinephrine Life Support 109

EMDocs

JANUARY 3, 2024

He has been taking increased doses of torsemide without improvement in his symptoms and was directed to the ED for inpatient therapy. Now, a remote outpatient pulmonary arterial pressure monitor and other heart failure detection devices (Table 1) are available that you may begin to see in your ED.

Defibrillator 113

Defibrillator Allergic Reaction ED ALS 113

EMDocs

NOVEMBER 1, 2023

A 39-year-old male with history of achalasia with recent endoscopic dilation 24 hours prior presents to the ED for progressively worsening chest pain with radiation to his left shoulder. 4 Prompt consultation is imperative with thoracic surgery, interventional radiology (IR), gastroenterology (GI), and/or critical care.

Critical Care 93

Critical Care ED EMS OR 93